Objective:To make up a portable,economic drainage device to prevent the development of pocket hematoma and avoid the additional therapies of pocket hematoma.Methods:Between 2003 and 2006,a total of 265 devices were im...Objective:To make up a portable,economic drainage device to prevent the development of pocket hematoma and avoid the additional therapies of pocket hematoma.Methods:Between 2003 and 2006,a total of 265 devices were implanted at our institution.The 89 high-risk patients were determined by the predictors of hematoma occurrence(marasmatic elder,inevitable oral antiplatelet/anticoagulation therapy,venous pressure increased by other comorbidity,the deficiency of the clotting mechanism for hepatic diseases,or incognizable severe intraoperative bleeding),and other 186 patients were included in non-high-risk group.The 89 high-risk patients were randomized into treatment and control subgroups by sortition.Surgical procedures differed only by the application of the portable,economic drainage device prior to wound closure in treatment subgroup.Results:The incidence of pocket hematoma was 4.3% in treatment subgroup,18.6% in control subgroup and 2.7% in non-high-risk group,leading to 2,6 and 3 patients' prolonged hospitalization,respectively.The additional cost due to pocket hematoma was lower(1.5 times) in the treatment group compared to the control group.There wasn't antidromic infection and delayed cure of the skin incision with the use of our drainage device within 6 months.Conclusion:Our portable drainage device was made up easily and quickly.It could decrease the total cost of hospitalization,did not increase the other adverse events and seemed to be suitable for such patients with a tendency to develop pocket hematoma undergoing the implantation of pectoral pacemakers,implantable cardioverter defibrillator,or cardiac resynchronization therapy.展开更多
目的探讨高龄老年患者(≥80岁)认知功能障碍(cognitive impairment,CI)对起搏器植入术后早期囊袋血肿的影响。方法分析2007年3月至2015年7月期间在广东省人民医院行永久性心脏起搏器植入术高龄老年181例患者的CI对术后1个月囊袋血肿并...目的探讨高龄老年患者(≥80岁)认知功能障碍(cognitive impairment,CI)对起搏器植入术后早期囊袋血肿的影响。方法分析2007年3月至2015年7月期间在广东省人民医院行永久性心脏起搏器植入术高龄老年181例患者的CI对术后1个月囊袋血肿并发症的影响。其中VVI/VVIR单腔起搏器植入36例,DDD/DDDR双腔起搏器植入145例;根据简易智力状况检查法(mini-mental state examination,MMSE)评分结果将患者分为二组:无CI组98例和CI组83例。结果术后1个月内23例(12.7%)患者发生囊袋血肿,无CI组和CI组分别有5例(5.1%)和18例(21.7%),两组比较差异有统计学意义(P<0.01)。其中术后未应用抗血栓药患者139例有16例(11.5%)发生了囊袋血肿,无CI组和CI组分别有3例(4.0%)和13例(20.3%),两组比较差异有统计学意义(P<0.01)。结论高龄老年患者的CI与起搏器植入术后囊袋血肿并发症的发生有关,应重视高龄老年患者认知功能障碍对囊袋血肿并发症的影响。展开更多
文摘Objective:To make up a portable,economic drainage device to prevent the development of pocket hematoma and avoid the additional therapies of pocket hematoma.Methods:Between 2003 and 2006,a total of 265 devices were implanted at our institution.The 89 high-risk patients were determined by the predictors of hematoma occurrence(marasmatic elder,inevitable oral antiplatelet/anticoagulation therapy,venous pressure increased by other comorbidity,the deficiency of the clotting mechanism for hepatic diseases,or incognizable severe intraoperative bleeding),and other 186 patients were included in non-high-risk group.The 89 high-risk patients were randomized into treatment and control subgroups by sortition.Surgical procedures differed only by the application of the portable,economic drainage device prior to wound closure in treatment subgroup.Results:The incidence of pocket hematoma was 4.3% in treatment subgroup,18.6% in control subgroup and 2.7% in non-high-risk group,leading to 2,6 and 3 patients' prolonged hospitalization,respectively.The additional cost due to pocket hematoma was lower(1.5 times) in the treatment group compared to the control group.There wasn't antidromic infection and delayed cure of the skin incision with the use of our drainage device within 6 months.Conclusion:Our portable drainage device was made up easily and quickly.It could decrease the total cost of hospitalization,did not increase the other adverse events and seemed to be suitable for such patients with a tendency to develop pocket hematoma undergoing the implantation of pectoral pacemakers,implantable cardioverter defibrillator,or cardiac resynchronization therapy.
文摘目的探讨高龄老年患者(≥80岁)认知功能障碍(cognitive impairment,CI)对起搏器植入术后早期囊袋血肿的影响。方法分析2007年3月至2015年7月期间在广东省人民医院行永久性心脏起搏器植入术高龄老年181例患者的CI对术后1个月囊袋血肿并发症的影响。其中VVI/VVIR单腔起搏器植入36例,DDD/DDDR双腔起搏器植入145例;根据简易智力状况检查法(mini-mental state examination,MMSE)评分结果将患者分为二组:无CI组98例和CI组83例。结果术后1个月内23例(12.7%)患者发生囊袋血肿,无CI组和CI组分别有5例(5.1%)和18例(21.7%),两组比较差异有统计学意义(P<0.01)。其中术后未应用抗血栓药患者139例有16例(11.5%)发生了囊袋血肿,无CI组和CI组分别有3例(4.0%)和13例(20.3%),两组比较差异有统计学意义(P<0.01)。结论高龄老年患者的CI与起搏器植入术后囊袋血肿并发症的发生有关,应重视高龄老年患者认知功能障碍对囊袋血肿并发症的影响。
